• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.4
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• pp.143-150
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• 2018

The number of geriatric patients seeking dental service is ever-rising because of increased life expectancy, also with problem of increased chronic medical conditions. One of them are patients on anti-thrombotic medication. Bleeding complication after minor oral surgery by anti-thrombotic agents is of concerns to dentists on dental management of these patients. Risk and benefit of the anti-thrombotic agents must be weighed before initiating dental procedures, which should be established as a treatment guideline. Purpose of the paper is to optimize the management of the dental patients on antithrombotic medication via standardization of treatment protocol of such a patient.

• Journal of Korean Academy of Nursing
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• v.38 no.2
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• pp.298-309
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• 2008

Purpose: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. Methods: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. Results: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. Conclusion: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.3
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• pp.187-195
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• 2022

Background: This retrospective study investigated the incidence rate of accidental foreign body aspiration and ingestion according to patient sex, age, and dental department. This study aimed to verify whether the incidence rate is higher in geriatric than in younger patients and whether it is different among dental departments. Methods: Accidental foreign body aspiration and ingestion cases were collected from electronic health records and the safety report system of Yonsei University Dental Hospital from January 2011 to December 2017. The collected data included patients' age, sex, medical conditions, treatment procedures, and foreign objects that were accidentally aspirated or ingested. The incidence rate was calculated as the number of accidental foreign body aspirations and ingestions relative to the total number of patient visits. Differences depending on the patients' sex, age, and dental department were statistically identified. Results: There were 2 aspiration and 37 ingestion cases during the 7-year analysis period. The male to female incidence ratio was 2.8:1. The incidence rate increased with age and increased rapidly among those aged 80 years or older. Seven of the 37 patients with accidental foreign body ingestion had intellectual disability, Lou Gehrig's disease, dystonia, or oral and maxillofacial cancer. The incidence rate was highest in the Predoctoral Student Clinic and the Department of Prosthodontics. The most frequently swallowed objects were fixed dental prostheses and dental implant components. Conclusion: The incidence rate of accidental foreign body aspiration and ingestion differed according to patient sex, age, and dental department. Dental practitioners must identify high-risk patients and apply various methods to prevent accidental foreign body aspiration and ingestion in dental clinics. Inexperienced practitioners should be particularly careful.

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.2
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• pp.264-274
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• 2001

About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.5
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• pp.207-213
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• 2014

Fractures of the mandible occur with a greater frequency in the elderly. This study reports three cases of edentulous atrophic mandible fracture in elderly patients treated with open reduction technique. Three patients who presented with edentulous atrophic mandible fractures underwent surgical management using open reduction and internal fixation. After treatment, clinical evaluations and postoperative complications were examined with postoperative x-ray. Patients were followed with clinical and radiographic examinations. In the postoperative clinical evaluation, two male patients healed well, but one female patient complained of pain and swelling. In radiographic examinations, no union delay or lack of fusion was observed in the edentulous area. Open reduction technique is a viable treatment option for the edentulous atrophic mandible fractures in geriatric patients.

• Journal of Veterinary Clinics
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• v.33 no.4
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• pp.231-233
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• 2016

A 10-year-old intact female, mixed breed dog presented with abdominal distention of 2 months duration and three days of decreased appetite. The patient was conscious and no other gross abnormalities were noted. A tentative diagnosis of idiopathic massive hematoma or hemangiosarcoma was made on evaluating all clinical findings. Splenectomy was performed for treatment of abdominal distention and histopathological investigation was initiated to confirm the diagnosis. The hematoma was extremely massive on gross morphology, with the size of $20.2{\times}12.4cm$ and the splenic mass was diagnosed as hematoma formation, with moderate to marked lymphoid hyperplasia and adjacent moderate extramedullary hematopoiesis, based on microscopic description of spleen histology. This is the first case report in veterinary literature of a dog with extremely rare splenomegaly, an unusually large hematoma, with no malignancy or remarkable clinical signs.

• The Journal of Korean Physical Therapy
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• v.20 no.2
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• pp.43-48
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• 2008

Purpose: The purpose of this study is to investigate the importance of grade decision and role of physical therapist which follows enforcement of elderly long-term residential care insurance system. Methods: One of the data from grade decision meeting in Bukgu, Busan on 2007 which was 88 case of attached finding of doctor was compared with findings of visited investigator. Result: Eighty-four investigation subjects had 186 diseases that included stroke and arthritis, requiring the need for physical therapeutic approaches. In addition, the results of the door-to-door research project in the northern district of Busan showed that there was no match out of 88 subjects who submitted the viewpoint of the doctor. Such a result was produced as the doctors did not diagnose the patient directly, but rather the diagnoses were obtained from guardians and a door-to-door researcher who had a poor understanding of geriatric motion and function. Conclusion: To enforce long-term care successfully, a re-investigation should be performed for the welfare of the aged.

• Journal of Korean Physical Therapy Science
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• v.27 no.2
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• pp.80-87
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• 2020

Background: The purpose of this study was to investigate the effect of the use of an alternative input device on the patient's work performance and satisfaction in patients with cerebral palsy who cannot use computers. Design: Case Series Description. Methods: The participant was one adult cerebral palsy. The three tasks were applied with an alternative input device (Quick-Glance), 1 session an hour, 3 times a week, a total of 12 times for 4 weeks. The assessment was using the Canadian Occupational Performance Measure (COPM). The evaluation was performed pre-test before the intervention, post-test after the last intervention, and follow-up after one month. Results: The COPM(Satisfaction and performance scores) showed 3 points for pre-test, 7 points for post-test, and 7 points for follow-up. Conclusion: Purposeful computer work activity, which is an alternative input device, has a positive effect on work performance and satisfaction of cerebral palsy patients who are difficult to use computer.

• Health Policy and Management
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• v.10 no.1
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• pp.148-173
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• 2000

This thesis is a kind of case report on the managerial difficulties and strategies to overcome them for the rural hospitals in Korea. We examined environmental situations and SWOT(Strength, Weakness, Opportunity, Threat) of the hospitals, and suggested some strategies to improve the hospital business through analysing secondary data and brief survey to staffs and patients at 3 case hospitals. Among the strategies were included establishment of their identity as community hospitals, positioning towards high-touch services rather than high-tech services to improve their competence. For this positioning, patient satisfaction should be emphasized to make rapport with the residents in the community, and a few service areas should be selected and strengthened. Emergency care and geriatric health services are recommended to be covered strongly, because rural hospitals are usually the one and only hospital in the region and rural communities have aged population structure. In addition to these, networking is necessary among rural hospitals nationwide and with local clinics and tertiary hospitals near urban areas. And also, complementary role division with community health post should be developed to lessen the competitive relationship between public and private sectors. To support these strategies, fresh organizational culture should be built up to make hospital staff creative and enthusiastic on their job. Finally, inducement of governmental assistance will be necessary to make the environment advantageous to the rural hospitals.

• Annals of Geriatric Medicine and Research
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• v.22 no.4
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• pp.204-207
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• 2018

Mycobacterium abscessus comprises rapidly growing mycobacteria, and the clinical manifestations of M. abscessus skin infection include papule, nodule, ulcer, scar and mixed form. The cutaneous infections have been reported due to minor trauma, cosmetic therapy, acupuncture and disseminated infection. A 75-year-old man presented with pruritic diffuse various sized erythematous papuloplaques and pustules on the neck and chest for 2 months. The cutaneous lesions were spread around the wound of the shaving on the neck. The histopathologic findings were consistent with abscess showing infiltrations of neutrophils and lymphocytes in the dermis and negative findings were observed on immunohistochemical stain including acid-fast bacilli stain. One month later, mycobacterial culture result showed positive findings, and the pathogen was identified by reversetranscriptase polymerase chain reaction with hybridization. The patient was treated with combination of clarithromycin and ethambutol for 5 months and there is no evidence of recurrence after 6 months of follow-up. Herein, we report a case of M. abscessus cutaneous infection through minor trauma caused by shaving in the elderly.